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JAMA Revisited
June 25, 2014

Interrelation of Bile Pigment and Hemoglobin

JAMA. 2014;311(24):2548. doi:10.1001/jama.2014.6619

Until recently it was generally held that the bile pigments are formed in the liver from hemoglobin liberated on the disintegration of red blood corpuscles. Views have since been entirely changed, however, by the demonstration that cells other than those of the liver have the capacity of converting the blood pigment into bile pigment at a rapid rate.1 The theory of an extrahepatic origin of bile pigments has become firmly established in present-day physiology. Indeed, there is evidence that bile pigment is not necessarily related to the destruction of red blood cells and hemoglobin but may have its origin directly in the food intake. This conclusion, however, remains debated.2 It is not to be imagined, say the physiologists, that the destruction of blood and formation of bile occur only in certain organs. They probably take place in all organs; and in the color of a bruise there is in reality the formation of bile pigment locally.…

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